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Children's Shyness, Frontal Brain Activity, and Anxiety in the Perioperative Context
Cheryl H T Chow1, Kristie L Poole1, Richard Y Xu1,2
1Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON L8S 4L8, Canada.
Insights
Shy children with higher brain activity (lower frontal alpha EEG power) experienced more preoperative anxiety. This suggests frontal brain patterns may amplify anxiety in shy children facing surgery.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Health
Background:
- Preoperative anxiety is common in children undergoing surgery, impacting outcomes.
- Individual differences in children's responses to surgical stress are not well understood.
- Shyness is a personality trait linked to anxiety, but its interaction with physiological responses in surgical contexts is unclear.
Purpose of the Study:
- To investigate if anterior brain electrical activity moderates the relationship between shyness and preoperative anxiety in children.
- To explore individual differences in children's anxiety responses to impending surgery.
- To examine the ecological validity of laboratory findings on shyness, brain activity, and anxiety in a real-world surgical setting.
Main Methods:
- Seventy children (8-13 years) undergoing elective surgery participated.
- Shyness was assessed via self-report one week before surgery.
- Preoperative anxiety and electroencephalography (EEG) frontal brain activity were measured on the day of surgery.
Main Results:
- Frontal EEG alpha power moderated the link between shyness and anxiety.
- Shy children with lower frontal alpha power (higher cortical activity) reported greater anxiety.
- This association was not significant for shy children with higher frontal alpha power (lower cortical activity).
Conclusions:
- Frontal brain activity patterns may amplify anxiety responses in shy children facing surgery.
- Findings extend previous research on shyness, frontal brain activity, and anxiety to a real-world surgical context.
- Understanding these neural correlates can inform interventions for pediatric surgical anxiety.
Abstract:
Although preoperative anxiety affects up to 75% of children undergoing surgery each year and is associated with many adverse outcomes, we know relatively little about individual differences in how children respond to impending surgery. We examined whether patterns of anterior brain electrical activity (i.e., a neural correlate of anxious arousal) moderated the relation between children's shyness and preoperative anxiety on the day of surgery in 70 children (36 girls, Mage = 10.4 years, SDage = 1.7, years, range 8 to 13 years) undergoing elective surgery. Shyness was assessed using self-report approximately 1 week prior to surgery during a preoperative visit (Time 1), preoperative anxiety was assessed using self-report, and regional EEG (left and right frontal and temporal sites) was assessed using a dry sensory EEG headband on the day of surgery (Time 2). We found that overall frontal EEG alpha power moderated the relation between shyness and self-reported preoperative anxiety. Shyness was related to higher levels of self-reported anxiety on the day of surgery for children with lower average overall frontal alpha EEG power (i.e., higher cortical activity) but not for children with higher average overall frontal alpha EEG power (i.e., lower cortical activity). These results suggest that the pattern of frontal brain activity might amplify some shy children's affective responses to impending surgery. Findings also extend prior results linking children's shyness, frontal brain activity, and anxiety observed in the laboratory to a real-world, ecologically salient environment.
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